When hospice reverts to the lowest common denominator and leaders obsess about metrics, it's time to speak. Self-inflated leaders assume clinicians give until their backs break, given no raises for years. A clinical ladder is a rainbow’s pot of gold. Others have a sorrier job and must be motivated by money. Abysmal leaders dangle extrinsic rewards for admission, hiring and EDBITA targets. “Sign on” bonuses entice people into a poor work environment. Employees’ voice equals their raise, zero.

Monday, October 28, 2013

Regarding the Gentiva-Capstar agreement: Are you suggesting the expert in Community Care would pick a low risk measure to ensure they are compensated at a maximum level (a combined $1,750,000) vs. getting nothing, nada, zero for their expertise?

StrangeTony

Reply from Anonymous - YES!

Comment from StrangeTony - That sounds like something the Generic Hospice bunch would arrange to enrich the small band of brothers at the top.

Thursday, October 24, 2013

I find it amazing how people at the top find ways to enrich one another. Does this pass the smell test, especially if the parties have knowledge that the condition stipulating payment will occur?

Gentiva entered into a five-year consulting agreement (the “Consulting Agreement”)
with Javelin Healthcare Holdings, LLC, now named Harden Healthcare Holdings, LLC and an indirectly owned subsidiary of Gentiva, and Capstar, pursuant to which Capstar will provide the Surviving Company with certain transitional, strategic or commercial matters, including assistance with the development and maintenance of relationships with key customers and third party payors, and any other services as may appear to the Surviving Company from time to time to be
necessary or appropriate in connection with the foregoing.

Pursuant to the Consulting Agreement, Gentiva and the
Surviving Company have agreed to pay Capstar an amount equal to $1.0 million per year (commencing as of January 1, 2014) if the Community Care Rate (as defined in the Consulting Agreement) exceeds the Base Community Care Rate (as defined in the Consulting Agreement). If for a given year the Community Care Rate fails to exceed the Base Community Care Rate, Capstar will not be entitled to any payment under the Consulting Agreement for such year.

Additionally, on the Closing Date, Gentiva entered into an agreement pursuant to which Capstar Investment Partners, L.P., a Texas limited partnership in which Mr. Hicks has an indirect material interest (“Capstar L.P.”), has agreed, to terminate a certain sublease agreement in connection with the consummation of the Mergers. Under this agreement, Gentiva has agreed to pay Capstar L.P., for each of five calendar years commencing January 1, 2014, an amount equal to either (i) $750,000 if the Community Care Rate exceeds the Base Community Care Rate for such year and (ii) zero dollars if the Community Care Rate fails to exceed the Base Community Care Rate for such year.

For fiscal year 2014 and thereafter, this component will be determined
by summing total reported foster/companion care coordinator wages and
allocated payroll taxes and benefits from the most recently available
audited cost report, inflating those costs to the rate period and
dividing the resulting product by the total number of foster care units
of service reported on that cost report.

If companion care rates automatically inflate in 2014 Capstar's $1.75 million payment is in the bag. One might've thought $409 million in cash and stock would've been enough for Capstar. It looks like they may pull another $8.75 million from Gentiva. How many people will be fired to fund this private equity enrichment plan?

As for Capstar's commitment to quality, none of their hospice physicians are board certified in hospice and palliative medicine. All of our site's physicians are board certified.

This deal looks more financial and less patient care oriented as news dribbles out. Leading provider now means "just a little bit better than our competition."

Our site used to provide the best service, hands down. Gentiva took that away. How much lower can it go as executive enrichment grows? Sad days, indeed.

Anonymous

P.S. - The Chairman of Capstar Partners, now Vice Chair of Gentiva's board, will sell nearly 2.3 million shares of GTIV, valued at over $27 million. Gentiva employees got their PTO benefit reduced.

Saturday, October 19, 2013

Gentiva executives stand ready to integrate local sites now that they've closed the Harden acquisition. Our Chairman of FUN said they've already reorganized corporate and regional leadership. This resulted in a number of people losing their jobs, which seems the distinct opposite of fun.

This has the feel of the 1,000 person layoff Gentiva conducted in late 2011. Our site lost six people in that round.

Guess who'll be making decisions about us going forward? People who don't know jack squat about our site. This is how many corporate support people we've had in the last two years:

Doing the math, that's four positions, occupied by 14 different people over two years:

10/4 = 2.5

That's 250% turnover in twenty four months. A corporate person hardly gets to meet people at our site before they're fired, moved or replaced. This explains why no one has ferreted out our toxic Branch Manager (BM). It takes skill and attention to discern this person is abusive and incapable of leading in a consistent, collaborative manner.

From my seat OneGentiva's tag line should be "Rampant Chaos." What will Gentiva's Corporate Talking Heads' do next to traumatize our site? The answer should be forthcoming in several weeks. One thing's guaranteed. Due to exceedingly poor communication, everything will be a surprise.

Anonymous

P.S. The firings and surprises have already started. It didn't take two weeks. I expect many more corporate "support" changes. Can Gentiva get turnover over 300%? I know it's a stretch goal, but this mendacious bunch can surely do it.

P.P.S. In the 3rd Quarter earnings call CEO Tony Strange announced 100 positions gone as a result of synergies created by OneGentiva and the Harden deal. He expects more as overlapping territories are addressed by the end of the year. Chaos continues.

P.P.S.S. Gentiva hit 300% turnover in corporate support positions for our site. They did so by giving us another Area Operations Manager and Area Sales Manager. Sixteen people have now occupied four slots in two years.

Saturday, October 12, 2013

It sounds like things are getting crazy at Gentiva with all those corporate machinations. Generic Hospice isn't much different. We've been owned by four different companies. Thank God none ever came around to visit. They were just a voice at the other end of the phone, barking orders.

The Generic rabbit hole recently had our Branch Manager (BM) fire our best chaplain for working for free. The chaplain had been warned for:

1) Working overtime to meet patient and grievers needs
2) Working overtime to meet patient and grievers needs without permission from management
3) Working to meet patient patient and grievers needs off the clock, i.e. not putting down their hours worked.
4) Living, which was in direct opposition to our Branch Manager's desire

This chaplain inspired the rest of us by always listening to our concerns, issues and problems. Our BM could care less about any staff needs or concerns, unless they miraculously intersected with their needs.

Anyway, the BM canned our chaplain, right there in a public hallway. Then the darnedest thing happened. The chaplain raised their cross and proceeded to conduct an exorcism.

Just as the chaplain got out "Satan, I rebuke you" the BM, with full facial contortions, shouted, "Get the _uck out of my hospice!" The BM grabbed the cross and began wrestling for control. The struggling pair lunged left, causing the chaplain's back to hit the wall hard. The chaplain worked to regain their breath. In doing so the chaplain faced their former boss' mad, bulging eyes.

After reaching into their jacket pocket the chaplain threw something white into the BM's face. The BM screamed in pain, then seemingly shriveled to nothing before our very eyes. The chaplain stood over the shell of empty clothes, saying "Get the _uck out of my faith."

I asked the chaplain what they'd thrown. The answer, "Exorcism salt. Does in a corporate slug every time." I asked the chaplain to drive a tanker load to our corporate office. They should arrive any minute.

Free at last, free at last, thank God almighty we might be free at last of abysmal management. Your partner in suffering foolish leaders who can't manage what they can't understand.

Thursday, October 10, 2013

Get this: In Spring 2013 Gentiva Hospice executives confessed to making a mistake by treating hospice like home health. They confessed it took three years and a 1,000 employee layoff to learn hospice was not home health. The edict generating corporate office could've asked hospice employees post-Odyssey merger and learned that long ago.

Instead they brought back the Chairman of Fun, who engineered Gentiva's corporate restructuring pre-merger with Harden Healthcare. The C-Suite took the same leaders who couldn't tell the difference between hospice and home health and reshuffled the deck. Home Health came out on top, with Hospice lucky to be in the five card draw. The winners will be in charge of hospice, home health and community care.

While it takes a different clinical mindset to execute home health (restorative) vs. hospice (palliative), apparently no particular management experience or orientation is required. At Gentiva sites are specialized, while bad management is universal.

Despite a requirement that employee satisfaction be surveyed annually at the site level, I've never seen one in my years of employment. It's patently laughable that the divided Gentiva ever put patients or employees first. Gentiva.1 issued top down edicts, completely ignoring longstanding talent and experience at the site level.

The Fun Chair removed the dot at Gentiva.1. Here's my suggestion for the new corporate tag line

Gentiva1 : Kick-starting Chaos

Add Harden to this deformed company and things should get exponentially chaotic. That is if credit markets hold up and banks listed at the top of this post actually fund the deal. Strange days indeed.

Wednesday, October 2, 2013

Somewhere in Gentiva's hospice acquisition evolution it picked up YCCOM, which stands for "You Can Count on Me." Maybe it had real meaning before the third or fourth buyout. The other day a co-worker offered other interpretations of YCCOM.

"You Can Crap on Me"

"You Can Count on Mismanagement"

"You Can't Change our Mind"

"Your Controlling Character Obliterates Motivation"

"Your Conscience Cramps our Money"

"Your Counterfeit Chumminess Offends Me"

"Youthful Company Cheerleaders Oust Meaningfulness"

"Your Control Curtails our Morale"

"Your Creativity Contradicts our Management"

"Yellow Cowards Causing Outright Misery"

"You Can't Come (up short) on Metrics"

Other Gentivites: Feel free to send any YCCOM's to strangetonygu@gmail.com. It's his Generic Hospice blog. I only resonate with strangetony from a Gentiva perspective. YCCOM away!